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REVEALING AND ACKNOWLEDGING VALUE JUDGMENTS IN HEALTH TECHNOLOGY ASSESSMENT

Part of: Special Collection - Methods

Published online by Cambridge University Press:  30 March 2015

Bjørn Hofmann ,
Irina Cleemput ,
Kenneth Bond ,
Tanja Krones ,
Sigrid Droste ,
Dario Sacchini  and
Wija Oortwijn
Bjørn Hofmann
Affiliation:
University College of Gjøvik and University of Oslo, bjoern.hofmann@hig.no
Irina Cleemput
Affiliation:
Hasselt University and Belgian Health Care Knowledge Centre (KCE)
Kenneth Bond
Affiliation:
Canadian Agency for Drugs and Technologies in Health
Tanja Krones
Affiliation:
University Hospital/University of Zürich
Sigrid Droste
Affiliation:
Institute for Quality and Efficiency in Healthcare (IQWiG)
Dario Sacchini
Affiliation:
Institute of Bioethics, “Agostino Gemelli” School of Medicine, Universita Cattolica del Sacro Cuore
Wija Oortwijn
Affiliation:
Ecorys Netherlands
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Abstract

Background: Although value issues are increasingly addressed in health technology assessment (HTA) reports, HTA is still seen as a scientific endeavor and sometimes contrasted with value judgments, which are considered arbitrary and unscientific. This article aims at illustrating how numerous value judgments are at play in the HTA process, and why it is important to acknowledge and address value judgments.

Methods: A panel of experts involved in HTA, including ethicists, scrutinized the HTA process with regard to implicit value judgments. It was analyzed whether these value judgments undermine the accountability of HTA results. The final results were obtained after several rounds of deliberation.

Results: Value judgments are identified before the assessment when identifying and selecting health technologies to assess, and as part of assessment. They are at play in the processes of deciding on how to select, frame, present, summarize or synthesize information in systematic reviews. Also, in economic analysis, value judgments are ubiquitous. Addressing the ethical, legal, and social issues of a given health technology involves moral, legal, and social value judgments by definition. So do the appraisal and the decision-making process.

Conclusions: HTA by and large is a process of value judgments. However, the preponderance of value judgments does not render HTA biased or flawed. On the contrary they are basic elements of the HTA process. Acknowledging and explicitly addressing value judgments may improve the accountability of HTA.

Keywords

MoralsEthicsTechnology AssessmentBiomedicalPersonal valueMoralityBiomedical technology assessmentValuesNorms
Type
Methods
Information
International Journal of Technology Assessment in Health Care , Volume 30 , Issue 6 , December 2014 , pp. 579 - 586
Copyright
Copyright © Cambridge University Press 2015 

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